✔️✔️17 & 18 - Surgery of Bladder & Urethra I & II 🟢

LECTURES 17 & 18 POWERPOINT INFO

LECTURES 17 & 18 POWERPOINT INFO

A surgical incision into the urinary bladder

What is a cystotomy?

LECTURES 17 & 18 POWERPOINT INFO

LECTURES 17 & 18 POWERPOINT INFO

A surgical incision into the urinary bladder

What is a cystotomy?

The creation of an opening into the bladder

What is a cytostomy?

Removal of a portion of the urinary bladder

What is a cystectomy?

An incision into the urethra

What is a urethrotomy?

Urinary bladder calculi

What is cystolithiasis?

Removal of urinary bladder calculi

What is cystolithetomy?

Trigone

What is the area of the bladder that is a smooth triangular portion of the mucous membrane at the base of the bladder where the ureters empty?

Prepubic catheterization

What is usually performed to provide cutaneous urinary diversion in animals with urethral obstruction or trauma?

Presence of urine in the abdominal cavity

What is uroabdomen?

Creation of permanent fistula into the urethra

What is a urethrostomy?

Trigone

What is this?

-Remove calculi

-Repair trauma

0Resect or biopsy neoplasms

-Correct congenital abnormalities

-Evaluation of urinary tract infection resistant to treatment

What are the indications for cystotomy?

-Struvite

-Calcium oxalate calculi

What are the most common canine uroliths?

Struvite calculi

What type of urolith in dogs is most frequently associated with infection?

Cystotomy

What surgery is used to treat urinary calculi?

Retrihydropropulsion

What is used to propel urethral stones back into the bladder?

Failure to remove all stones

What is the most common complications for cystotomy?

Hemorrhage

What is the main complication of urethrotomy?

Lithotripsy

What uses shock waves to break up stones in the kidney, bladder, or ureter?

-Provide cutaneous urinary diversion in animals with urinary obstruction, traumatized urethra, and surgically repaired urethra

-Bladder atony secondary to neurologic disease

-Prevention of overdistention of bladder after surgery

When is cystotomy indiciated?

-Male dogs to remove urethral calculi that cannot be retrohydropropulsed into the bladder

-Facilitate placement of catheters into the bladder

-Occasionally biopsy of obstructive lesion

What are the indications for urethrotomy?

-Remove calculi from distal penile urethra

-Place foley catheters into urinary bladder

What are the indications for prescrotal urethrotomy?

-Removal calculi lodged at ischial arch

-Place catheters into bladder of large male dogs

What are the indications for perineal urethrotomy?

-Recurrent obstructive calculi that cannot be managed medically

-Calculi that cannot be removed by retrohydropropulsion or urethrotomy

-Urethral stricture

-Urethral or penile neoplasia or severe trauma

-Preputial neoplasia requiring penile amputation

What are the indications for urethrostomy?

If castration is an option

When is scrotal urethrostomy preferred?

Perineal urethrostomy

What type of urethrostomy is routinely performed in cats?

Scrotal urethrostomy

What type of urethrostomy in dogs are preferred because the urethra is wider and more superficial and is surrounded by less cavernous tissue?

-Prevent recurrence of obstruction in male with feline idiopathic cystitis (FIC)

-Treat obstruction that cannot be eliminated by catheterization

-Treat strictures secondary to urethral obstruction and catheterization

What are the indications for feline perineal urethrostomy?

Urethral opening of insufficient diameter and predispose your patient to urinary tract blockage

In feline perineal urethrostomy, you pass a closed halsted mosquito hemostat up the urethra and passed to level of boxlocks without resistance. What could happen is you failed to perform this step?

LECTURES 17 & 18 NOTES

LECTURES 17 & 18 NOTES

removal of calculi

What is the most common reason for a cystotomy?

can seed the cancer into the abdominal wall if going through body wall rather than a catheter

If you suspect that there is transitional cell carcinoma, do not do a cystocentesis. Why?

apex

Which part of the bladder is good for placing stay sutures?

ventral

_____ approach is often prefered for a surgical approach for a cystotomy

tough

Is the bladder a delicate or tough organ?

simple continuous

What pattern do we use to close the bladder?

1. express - but be careful as you can push stones down the urethra

2. place catheter - can help push stones back up into the bladder, which may be helpful

3. intraoperative cystocentesis - come through the wall with a needle with/without suction

What can we do to empty the bladder if its too full?

stone formation

If there is any type of foreign body in the urinary bladder, there is propensity for _____

simple continuous on the mucosa & then the outer layer

How can we suture a very inflamed bladder, with potentially severe hemorrhage?

true

T/F - We always need to look at/analyze the stones themselves, not just the urine

cats

In [dogs/cats], struvite formation is not associated with infection

obstruct

In male dogs especially, if you get the stone too small and they push it down the urethra, they can _____

shorter

The female urethra is [longer/shorter] than a males

true

T/F - The urachal diverticula can be removed during cystotomy

didn't get all the stones

What is the #1 complication with stone removal surgery?

hemorrhage

What is the main complication of urethrotomy?

opening the abdomen, making a hole in the bladder, & placing device, suturing the bladder to body wall with device in place

Describe prepubic catheterization

getting the stones back into the bladder

What is our first "choice"/course of action when doing a urethrotomy?

urethra

The _____ really likes to hemorrhage!

yes - can use #15

Is it recommended to change the blade when cutting into the urethra?

boxlocks

During a feline perineal urethrostomy, the hemostat should be able to be passed to the level of the _____ without resistance (~5mm diameter)

skin

During a feline perineal urethrostomy, suture the urethral mucosa to the _____